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The Sepsis Six is the name given to a bundle of medical therapies designed to reduce mortality in patients with sepsis. [citation needed] Drawn from international guidelines that emerged from the Surviving Sepsis Campaign [1] [2] the Sepsis Six was developed by The UK Sepsis Trust. [3] (Daniels, Nutbeam, Laver) in 2006 as a practical tool to ...
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. [8] According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced. [9]
Disease severity partly determines the outcome. [6] The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and the risk of death from septic shock is 80%. [14] [15] [6] Sepsis affected about 49 million people in 2017, with 11 million deaths (1 in 5 deaths worldwide). [16]
SIRS is also closely related to sepsis, in which patients satisfy criteria for SIRS and have a suspected or proven infection. [2] [3] [4] [7] Many experts consider the current criteria for a SIRS diagnosis to be overly sensitive, as nearly all (>90%) of patients admitted to the ICU meet the SIRS criteria. [8]
In 1994, a new definition was recommended by the American-European Consensus Conference Committee [6] [10] which recognized the variability in severity of pulmonary injury. [51] The definition required the following criteria to be met: acute onset, persistent dyspnea; bilateral infiltrates on chest radiograph consistent with pulmonary edema
Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Finally, the Surviving Sepsis Campaign was established, in theory to raise awareness of severe sepsis and generate momentum toward the development of treatment guidelines. This marketing campaign was especially troublesome because Xigris has been linked to increased risk of serious bleeding in patients who used it as well as other concerns.
The Surviving Sepsis Campaign guidelines advocate intravenous hydrocortisone only in adults with septic shock and refractory hypotension. [4] The exact definition of this condition, the best ways to test for corticoid insufficiency in critically ill patients, and the therapeutic use of (usually low doses) of corticosteroids remains a subject of ...